Comparison of positional shift of supraglottic devices resulting from chest compressions: simulation using a manikin and automated chest compression system

Abstract

Background: The American Heart Association 2010 Guidelines for Resuscitation suggest the use of supraglottic devices as an alternative to tracheal intubation during cardiopulmonary resuscitation. This study aimed to evaluate supraglottic device displacement and the effect of tape fixation by simulation with a manikin and automated chest compression system. Methods: We placed eight supraglottic devices (ProSeal, i-gel, Classic, Soft Seal, Fastrack, Supreme, Ambu-aura-i, air-Q) into an advanced life support simulator, and compared no fixation and Durapore tape fixation conditions. After 5 min of automated chest compressions, positional shift of the supraglottic devices was measured. A total of five trials were carried out in each setting. Statistical analysis was carried out with two-way repeated measures ANOVA. P < 0.05 was considered significant. Results: Positional shift after 5 min of chest compressions were as follows: ProSeal, 0.68 +/- 0.26 cm; i-gel, 0.50 +/- 0.16 cm; Classic, 0.36 +/- 0.15 cm; Soft Seal, 0.32 +/- 0.08 cm; Fastrack, 0.20 +/- 0.07 cm; Supreme, 0.20 +/- 0.07 cm; Ambu-aura-i, 0.18 +/- 0.08 cm; and air-Q, 0.12 +/- 0.04 cm. Positional shift was larger with the ProSeal and i-gel compared with any of the other six supraglottic devices (P < 0.05). Conversely, positional shift was significantly smaller with the air-Q than the other supraglottic devices (P < 0.05). Tape fixation reduced positional shift for all supraglottic devices, with a significant reduction observed with ProSeal, i-gel, Classic, and Soft Seal. Conclusion: Simulation analysis revealed that positional shift of air-Q by chest compressions is smaller than those of seven other supraglottic devices.